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Comparison of Immediate Effects of Pain, Range of Motion and Treatment Satisfaction on Difference of Applying Joint Mobilization Levels in Patients With Acute Mechanical Neck Pain

급성 기계적 경부통 환자들의 관절가동술 적용 위치에 따른 통증과 가동범위와 치료 만족도의 즉각적인 효과 비교

  • Lee, Nam-yong (Dept. of Physical Therapy, The Graduate School, Daejeon University) ;
  • Kim, Suhn-yeop (Dept. of Physical Therapy, College of Health Medical & Science, Daejeon University)
  • 이남용 (대전대학교 일반대학원 물리치료학과) ;
  • 김선엽 (대전대학교 보건의료과학대학 물리치료학과)
  • Received : 2015.07.24
  • Accepted : 2015.09.02
  • Published : 2015.09.17

Abstract

The purpose of this study was to apply the joint mobilization technique to the level of segments with pain and to the level of segments with hypomobility respectively and compare the immediate effects of the joint mobilization technique on the pain, the active cervical range of motion (ROM), and treatment satisfaction of patients with acute mechanical neck pain. After the baseline assessment, forty-two patients were randomized into two groups: a painful group ($n_1=21$) that received joint mobilization at the most painful cervical spine level and a hypomobile group ($n_2=21$) that received joint mobilization at the most hypomobile cervical level. The patients received an intervention that applied unilateral posterior-anterior gliding for 5 minutes and two repetitions of 10 times of active extension motion with distraction. In the Wilcoxon signed-rank test, the painful group and the hypomobile group were improved significantly in all pain variables (p<.001), while the painful group was improved significantly in the active cervical flexion (p<.001), extension (p<.001), left side-bending (p<.01), right side-bending (p=.001), left rotation (p<.001), and right rotation (p<.001). The hypomobile group was significantly improved in active cervical flexion (p=.001), extension (p<.001), left side-bending (p<.05), right side-bending (p=.001), left rotation (p=.001), and right rotation (p<.01) after intervention. In the Mann-Whitney U test, there was no significant difference in any of the dependent variables after the intervention between the two groups, but the painful group was slightly superior to the hypomobile group in all variables except for the right lateral flexion ROM and treatment satisfaction. These outcomes suggest that the cervical joint mobilization may be applied to either the level of painful segments or the hypomobile segments for the treatment of patients with acute mechanical neck pain.

Keywords

References

  1. Ahn NU, Ahn UM, Ipsen B, et al. Mechanical neck pain and cervicogenic headache. Neurosurgery. 2007;60(1 Supp1 1):S21-S27.
  2. Aprill C, Bogduk N. The prevalence of cervical zygapophyseal joint pain. A first approximation. Spine (Phila Pa 1976). 1992;17(7):744-747. https://doi.org/10.1097/00007632-199207000-00003
  3. Aquino RL, Caires PM, Furtado FC, et al. Applying joint mobilization at different cervical vertebral levels does not influence immediate pain reduction in patients with chronic neck pain: A randomized clinical trial. J Man Manip Ther. 2009; 17(2):95-100. https://doi.org/10.1179/106698109790824686
  4. Bombardier C. Outcome assessments in the evaluation of treatment of spinal disorders: Summary and general recommendations. Spine (Phila Pa 1976). 2000;25(24):3100-3103. https://doi.org/10.1097/00007632-200012150-00003
  5. Binder A. The diagnosis and treatment of nonspecific neck pain and whiplash. Eura Medicophys. 2007; 43(1):79-89.
  6. Bronfort G, Evans R, Nelson B, et al. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine (Phila Pa 1976). 2001;26(7):788-797; discussion 798-799. https://doi.org/10.1097/00007632-200104010-00020
  7. Conroy DE, Hayes KW. The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome. J Orthop Sports Phys Ther. 1998;28(1):3-14. https://doi.org/10.2519/jospt.1998.28.1.3
  8. Creighton D, Kondratek M, Krauss J, et al. Ultrasound analysis of the vertebral artery during non-thrust cervical translatoric spinal manipulation. J Man Manip Ther. 2011;19(2):84-90. http://dx.doi.org/10.1179/2042618611Y.0000000005
  9. Dunning JR, Cleland JA, Waldrop MA, et al. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: A multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2012;42 (1):5-18. http://dx.doi.org/10.2519/jospt.2012.3894
  10. Ernst E, Canter PH. A systematic review of systematic reviews of spinal manipulation. J R Soc Med. 2006;99(4):192-196. https://doi.org/10.1258/jrsm.99.4.192
  11. Gross AR, Kay T, Hondras M, et al. Manual therapy for mechanical neck disorders: A systematic review. Man Ther. 2002;7(3):131-149. https://doi.org/10.1054/math.2002.0465
  12. Hing W, Reid DA, Monaghan M. Manipulation of the cervical spine. Man Ther. 2003;8(1):2-9. https://doi.org/10.1054/math.2002.0487
  13. Hoy DG, Protani M, De R, et al. The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010; 24(6):783-792. http://dx.doi.org/10.1016/j.berh.2011.01.019
  14. Hurwitz EL, Aker PD, Adams AH, et al. Manipulation and mobilization of the cervical spine: A systematic review of the literature. Spine (Phila Pa 1976). 1996;21(15):1746-1759; discussion 1759-1760. https://doi.org/10.1097/00007632-199608010-00007
  15. Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: Clinical outcomes from the UCLA neck-pain study. Am J Public Health. 2002;92(10):1634-1641. https://doi.org/10.2105/AJPH.92.10.1634
  16. Jull G, Bogduk N, Marsland A. The accuracy of manual diagnosis for cervical zygapophysial joint pain syndromes. Med J Aust. 1988;148(5):233-236.
  17. Kaltenborn FM, Kaltenborn BT, Morgan D, et al. Manual Mobilization of the Joints: Joint examination and basic treatment. Vol. 2: The spine. 5th ed. Oslo, Norli, 2009:51-68.
  18. Kamper SJ, Ostelo RW, Knol DL, et al. Global perceived effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status. J Clin Epidemiol. 2010;63(7):760-766. http://dx.doi.org/10.1016/j.jclinepi.2009.09.009
  19. Kanlayanaphotporn R, Chiradejnant A, Vachalathiti R. The immediate effects of mobilization technique on pain and range of motion in patients presenting with unilateral neck pain: A randomized controlled trial. Arch Phys Med Rehabil. 2009;90(2): 187-192. http://dx.doi.org/10.1016/j.apmr.2008.07.017
  20. Katavich L. Differential effects of spinal manipulative therapy on acute and chronic muscle spasm: A proposal for mechanisms and efficacy. Man Ther. 1998;3(3):132-139. https://doi.org/10.1016/S1356-689X(98)80003-9
  21. Kelly AM. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001;18(3):205-207. https://doi.org/10.1136/emj.18.3.205
  22. Kim SY. Effects of joint mobilization techniques on the joint receptors. Phys Ther Korea. 1996;3(2): 95-105.
  23. Krauss JR, Evjenth O, Creighton D. Translatoric spinal manipulation for physical therapists. Rochester, Lakeview Media LLC, 2006:41-58.
  24. Kulig K, Landel R, Powers CM. Assessment of lumbar spine kinematics using dynamic MRI: A proposed mechanism of sagittal plane motion induced by manual posterior-to-anterior mobilization. J Orthop Sports Phys Ther. 2004;34(2):57-64.
  25. Kulig K, Powers CM, Landel RF, et al. Segmental lumbar mobility in individuals with low back pain: In vivo assessment during manual and self-imposed motion using dynamic MRI. BMC Musculoskelet Disord. 2007;29(8):8.
  26. Maitland GD, Hengeveld E, Banks K, et al. Maitland's vertebral manipulation. 7th ed. London, Butterworth-Heinemann, 2005:61-84.
  27. McNair PJ, Portero P, Chiquet C, et al. Acute neck pain: Cervical spine range of motion and position sense prior to and after joint mobilization. Man Ther. 2007;12(4):390-394. https://doi.org/10.1016/j.math.2006.08.002
  28. Ostelo RW, de Vet HC. Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol. 2005;19(4):593-607. https://doi.org/10.1016/j.berh.2005.03.003
  29. Randall T, Portney L, Harris BA. Effects of joint mobilization on joint stiffness and active motion of the metacarpal-phalangeal joint. J Orthop Sports Phys Ther. 1992;16(1):30-36. https://doi.org/10.2519/jospt.1992.16.1.30
  30. Sambajon VV, Cillo JE, Gassner RJ, et al. The effects of mechanical strain on synovial fibroblasts. J Oral Maxillofac Surg. 2003;61(6): 707-712. https://doi.org/10.1053/joms.2003.50141
  31. Schomacher J. The effect of an analgesic mobilization technique when applied at symptomatic or asymptomatic levels of the cervical spine in subjects with neck pain: A randomized controlled trial. J Man Manip Ther. 2009;17(2): 101-108. https://doi.org/10.1179/106698109790824758
  32. Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine (Phila Pa 1976). 1997;22(4):435-440; discussion 440-441. https://doi.org/10.1097/00007632-199702150-00017
  33. Tousignant M, Duclos E, Lafleche S, et al. Validity study for the cervical range of motion device used for lateral flexion in patients with neck pain. Spine (Phila Pa 1976). 2002;27(8):812-817. https://doi.org/10.1097/00007632-200204150-00007
  34. Twomey LT. A rationale for the treatment of back pain and joint pain by manual therapy. Phys Ther. 1992;72(12):885-892. https://doi.org/10.1093/ptj/72.12.885
  35. Youdas JW, Carey JR, Garrett TR. Reliability of measurements of cervical spine range of motion-comparison of three methods. Phys Ther. 1991;71(2):98-104; discussion 105-106. https://doi.org/10.1093/ptj/71.2.98
  36. Zusman M. Central nervous system contribution to mechanically produced motor and sensory responses. Aust J Physiother. 1992;38(4):245-255. http://dx.doi.org/10.1016/S0004-9514(14)60567-5

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